Improving colorectal cancer screening disparities among Somali-speaking patients in an Internal Medicine Residency Clinic

Abstract

Colorectal cancer (CRC) is the third-most lethal cancer in the USA, and early detection through screening is crucial for improving outcomes. However, significant disparities in access and utilisation of CRC screening exist among patients with limited English proficiency. Our Quality Improvement (QI) team developed and implemented a video, featuring a Somali-speaking physician, created with input from internal medicine (IM) residents, patient education experts and community leaders to increase the rate of CRC screening uptake within a Somali-speaking population receiving primary care within an IM Residency Clinic. The baseline proportion of average-risk Somali-speaking patients who had successfully been screened for CRC was 46.3% (63/134). The proportion of patients agreeable to undergo CRC screening was assessed monthly from the beginning of video implementation (June 2022 to December 2022). We found that this intervention corresponded with a significant increase in willingness to undergo CRC screening from 36.4% to 100% during the early stages of intervention. At the end of our measurement timeframe, the proportion of the original population fully screened for CRC was 50.7% (68/134). Implementation of the video intervention was also assessed and determined to be minimally disruptive to the clinic flow.

Keywords: Health Behavior; Health Equity; Health Literacy; Healthcare quality improvement; PDSA.

Figure 1

Diagram of the described intervention within the clinic workflow. CRC, colorectal cancer.

Figure 2

Run chart demonstrating the number of patients who agreed to having a screening test ordered out of the total number of eligible patients exposed to the intervention (May–December 2022).

Figure 3

Survey responses from resident physicians on how disruptive the video intervention was to the clinic visit.